Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2022
Predictors of unrelieved symptoms in All of Us Research Program participants with chronic conditions.
Over half of American adults are diagnosed with a chronic condition, with an increasing prevalence being diagnosed with multiple chronic conditions. These adults are at higher risk for having unrelieved, co-occurring symptoms, known as symptom clusters. ⋯ We found meaningful relationships between demographic, healthcare access and utilization, and health-related factors and symptom phenotypes. With the increasing trends of American adults with one or more chronic conditions and a demand to individualize care in the precision health era, it is critical to understand the factors that lead to unrelieved symptoms.
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J Pain Symptom Manage · Dec 2022
"From the time you start with them until the Lord calls you": A qualitative study on the experiences and expectations of people living with advanced cancer interacting with palliative care services in Uganda, Nigeria and Zimbabwe.
A challenge facing the provision of palliative care in sub-Saharan Africa is a means of increasing coverage of services whilst maintaining quality. Developing an evidence base that reflects patients' experiences and expectations of palliative care services, the context within which services are provided, and the approaches adopted by services in caring for patients, could facilitate and inform the planning and development of patient-centered and responsive services. ⋯ Wide-ranging physical, psychological, social and financial impacts on participants were outlined. These concerns were largely met with compassionate and responsive care in the context of constrained resources. Study findings can inform evolving notions of patient-centred care for serious illnesses in the participating countries.
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J Pain Symptom Manage · Dec 2022
Prognostic Understanding and Goals of Palliative Radiotherapy: A Qualitative Study.
There is a paucity of data describing patients' expectations of goals of palliative radiotherapy (RT) and overall prognosis. ⋯ Unclear perceptions of goals of treatment and prognosis may motivate some patients to pursue unnecessarily aggressive cancer treatments. Patients desire prognostic information from their doctors, including radiation oncologists, who are important contributors to goals of care discussions and may improve patient understanding and well-being by using restorative rather than combat-oriented language.
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J Pain Symptom Manage · Dec 2022
Patient Preferences for Rescue Medications in the Treatment of Breakthrough Cancer Pain.
The discrete choice experiment (DCE) is conducted in this study to discuss Chinese cancer patients' risk-benefit preferences for rescue medications (RD) and their willingness to pay (WTP) in the treatment of breakthrough cancer pain (BTcP). ⋯ For Chinese cancer patients, especially those with moderate/severe cancer pain, the priority is to relieve the BTcP more rapidly and reduce adverse drug reactions more effectively. This study indicates these patients' expectations for the quick control of breakthrough pain and their emphasis on the reduction of adverse reactions. These findings are useful for doctors, who are encouraged to communicate with cancer patients about how to better alleviate the BTcP.
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J Pain Symptom Manage · Dec 2022
Creating KidneyPal: A Specialty-Aligned Palliative Care Service for People with Kidney Disease.
Patients with kidney disease have notable unmet palliative care needs and represent an underserved population for specialty palliative care teams. ⋯ The creation of KidneyPal led to us to serve a new cohort of patients with specialty palliative care. We grew over time to serve the full range of patients with kidney disease as defined by our nephrology service lines. We succeeded in doing so by embedding in nephrology and building relationships with those caring for people with kidney disease while tailoring our service and interventions over time.